Postinsertion Problems Assist Lec Sabreen W Aswad Assist
Post-insertion Problems Assist. Lec. Sabreen W. Aswad Assist. Lec. Manar Eyad Assist. Lec. Humam Mahmood
• Loss of natural teeth and subsequent alveolar ridge resorption has a significant effect on appearance and function. • Denture fabrication and insertion are not the final steps in the treatment. • Many patients with newly fabricated dentures continues the experience difficulty in adapting to them. • These problems may be transient or they may be serious enough
• There is some patient factor either age, gender , medical or psychological status can affect the success of treatment. • the most frequent complaints with removable prosthesis are those pertaining to esthetic , retention, stability and comfort while eating. • The factor that most often appears to have an impaction either success or failure of prosthesis is esthetic
• Patient satisfaction is critical determinant in the success or failure of removable denture therapy. The prosthodontist needs a thorough knowledge of anatomy, physiology, pathology and psychology to treat these problems.
Ø Satisfaction with dentures is impacted by factors such as denture quality, available denture-bearing area, the quality of the dentist-patient interaction, previous denture experience, the patient personality and psychological well-being. Ø No single fabrication technique for dentures has been proven to be superior and the technical quality of dentures accounts for less than half the total treatment success.
• Most of the complaints associated with complete dentures are actual and not psychological • the most common causes of discomfort for a RPD
• Many authors did a study on adaptation to complete dentures. They concluded that good denture retention facilitates the adaptation process. • While other authors did a study on the correlation between the quality of life, and denture satisfaction in elderly complete denture wearers and concluded that people who are well satisfied with their daily lives are also satisfied with their complete dentures.
• A dentist must realize the importance of interpersonal management skills, patient preparation, have understanding of denture function and denture limitations. A major role of the dentist is to guide and educate the patient through the process of complete denture therapy • Patients will thereby gain realistic expectations of what can and cannot be achieved, and dentists will understand what the patient really want
Prevalence of Post Insertion Complaints In Removable Partial Denture 20% ulceration 14% mastication 5% Debonding of teeth 31% loose 12. 5% speech 17. 5% Pain and soreness
Prevalence of Post Insertion Complaints In Removable complete Denture Food accumulation 7% 12% speech 30. 7 Pain and discomfort 23. 7% Retention 26. 6% Difficulty in eating
Factors causing problems for complete denture wearer may be grouped, essentially into four causes: 1. Adverse intra-oral anatomical factors. Eg: atrophic mucosa 2. Clinical factors. Eg: poor denture stability 3. Technical factors. Eg: failure to preserve the peripheral roll on a master cast 4. Patient adaptional factors
Ø the most critical factors are the patient adaptation factors. Ø Many patients with positive stereotypes may overcome errors of prescription. However, some patients are unable to adapt physically and/or psychologically to dentures that satisfy clinical and technical prosthodontics norms.
Ø An adequate history of the problem must be obtained and a careful examination of the mouth carried out so that an accurate diagnosis can be made and an appropriate treatment plan devised. Listening to the patient is the most important first step in the process and its importance cannot be over-emphasized.
Patient Adaptation Factors 1 - Noise on eating/speaking 2 - Eating difficulties 3 - Jaws close too far 4 - Cannot open mouth wide enough for food’. 5 - gagging
6 - Speech problems • Whistle on “s” sound • Lisp on “s” sound • Max. & mand. Incisors or premolars contact (s, sh , z, ch)sounds • When “f& v” sounds made
7 - esthetic • Fullness under nose • Depressed philtrum • Upper teeth sunken in • Too much of teeth are exposed
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